Saturday, February 14, 2015

Breathing Heartfelt Care



by: Kim Evanoski, CMC MPA LMSW

Sometimes on the walking trail I get to thinking about my week. The quiet solitude gives me important time for taking those long deep breathes to reflect and come to terms with life's events.

There are particular weeks in working in palliative care that I need time to think through how to facilitate a tough conversation that a care partner, being patient or family member, is ready to talk further on. As a practitioner I think part of my job is to prepare myself for assisting families in what I term as "heartfelt care". Heartfelt care is an activity like sitting around the table while sharing information that garners thoughtful thinking, goal setting and sometimes finite decisions towards understanding how we envision one's living, dying or death. Heartfelt care uses energy, needs focus and thoughtful breathing.

Over the years I have studied my own breathing and have asked my students to pay particular attention to how it affects their interactions with clients. I use breathing for the benefit of my professional self-care and for the benefit of providing heartfelt care to my families. Breathing is a powerful tool to share and to learn to facilitate when strong emotional feelings are present in the room. Do you ever notice your breathing when you are with patients? How do you breathe when giving heartfelt care? Do you notice your breathing after the meeting time?

I think practitioner's breathing and physical pace often affects the effectiveness of patient care. I think this is especially the case in geriatric care when "tender discussions" sometimes must come. My sense is we would fare better with facilitating heartfelt conversations by maneuvering ourselves to a slower pace with steady breathing; this encourages a sense of safety to talk and shows we have the time to seriously discuss important concerns. And this in turn helps us to continue good patient care because we understand the decisions which were made.

I think it is essential when providing caring patient interactions that we clearly focus and notice our breathing. Providing heartfelt care really starts by self-awareness towards a few key questions: 1. Before you walk in to the room do you take a few deep long breathes to feel centered and focused? 2. When you enter the part of the conversation that a hard decision will need to be made can you feel your breathe steady and provide calm assurances that have un-rushed time to listen? 3. Can you patiently wait for the decision to be announced by sitting and breathing slowly?

When I observe myself providing stillness, patience and steady breathing, care partners seem to know it's safe to explore and problem solve. Sometimes the patient's gratitude and resolution about their life emerges.

My sense from families is that giving time for breathing heartfelt care is as much of, if not more, their want in a palliative care partnership. Elders who have lived life for a long time seem to ask me for resolving conversations rather than technological miracles.

So today, I invite you to take a deep breathe for your own self-care and reflection.

What do you sense and listen to when you are providing heartfelt care?

A Heartfelt Valentine's Day to all in our GeriPal community! (That's you!)

Photo credit: Felicity White

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